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At the heart of general practice since 1960

Do we really understand poverty?

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He spent four days in police custody in a room measuring eight feet by five.

A half-read copy of Heat magazine wedged between his legs and a half-eaten lasagne next to his head. He’d been lifted by the cops for stealing from HMV and because he was wanted for a breach of bail he was given lodgings at the custody block until the court opened its doors the following Tuesday.

He didn’t sleep much over the next four days, dozing off here and there and when he did manage to drift off the collars of his sleep were roughly shaken by shouts and the slamming of cell doors.

When I saw him, covered in his blanket, bathed in the unending light of his cell, he had no idea what time of day it was and the only thing he looked forward to was his codeine. He was a diabetic and took tablets but he couldn’t remember what they were, and besides, I wasn’t his usual doctor so why the f*ck should he answer any of my questions?

He looked poor, not just tatty around the edges, he had that deep impoverished look about him, with basement skin and dirt in the grain and as he got up to take a cup of water from the turn-key a bandage flapped loosely against his leg ulcer.

‘Once I get out of here, I’m going to buy a big bottle of cider and chill out,’ he said, before adding, ‘I’ll have to see my GP as well, to get more of my meth.’

He was of course referring to methadone, that modern-day absinthe used to medicate against the here and now, but I suspect for him there’ll be no green fairy.

In primary care he’ll be a patient like any other.

He’ll get his one size fits all advice about smoking and diet and he’ll get his leaflet about diabetes and safe drinking. The boxes will be ticked and everything will be fine, as neat as a row of cells.

But as GPs do we really understand what we’re up against? Do we really know what to do when our delicate evidence-based culture crashes headlong with destitution?

Poverty, like the bright sun after four days in the cells can illuminate, but more often than not we just shield our eyes and look away.

Dr Kevin Hinkley is a GP in Aberdeen

Readers' comments (1)

  • I agree, we often dont know how best to tackle someones self-imposed health problems but that doesnt mean we should give up trying.

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